About Us
Our Team
Services
- Psychology
- Assessments
Appointments
Fees

About Us
Our Team
Services
- Psychology
- Assessments
Appointments
Fees

Appointments

ballpoint pens on pink notebook

ballpoint pens on pink notebook

Clients Name*

Is a Parent/Guardian filling out this form?*

Yes

No

Phone*

Your Email*

Birth Date*

Choose your benefits below:*

Medicare

NDIS

Private Health

None of the above

Describe your concerns*

Please choose your preferred appointment type below:*

Phone Consult

In-Person

Telehealth (Online)

Are you okay with seeing a Provisional Psychologist? A Registered Psychologist is Registered through Medicare, a Provisional isn't. The Gap fee will remain the same.*

Yes

No

Maybe. I need more information.

We operate Mondays to Wednesdays 9am to 5pm. Which day/s would suit you best?*

Monday

Tuesday

Wednesday

Thursday (Waitlist)

Friday (Waitlist)

Please select from the options below the appointments you are after:*

Therapy

Assessment

Groups

Other

If you selected 'Other' above please explain:

Want to schedule an appointment? Fill out this form to begin!

Southern Psychologists

15 Penney's Hill Road Hackham, SA 5163

0409 447 912

admin@southernpsychologists.net.au

“We show our respect and acknowledge the traditional custodians of this land, of elders past and present, on which this event takes place.”